Dr. Alexander Mazur, MD, clinical associate professor from the University of Iowa in Iowa City, said: "This device meets standards of other devices in the market and then adds CLS.

"My patients with heart failure have greater risk of falling due to the incidence of orthostatic hypotension and it is beneficial to have the option of using CLS to treat them."

Orthostatic hypotension occurs in 30-50%of elderly patients with disease or medication risk factors and is associated with falls, syncope and hospitalisation.

The study shows a 75% reduction in the prevalence of orthostatic hypotension with the CLS algorithm compared to an accelerometer, which most other CRT-D devices use.

Marlou Janssen, president of Biotronik, said: “The FDA has approved CLS as the only system to respond to acute mental stress and now this unique technology is available for more patients who can benefit from the expanded programming options of a quadripolar device.”